Abstract

Background: Insulin overdose can result in fatal hypoglycemia. We report on a diabetic child who received an unintentional insulin overdose.
Case presentation: A 13-year-old girl with type1 diabetes, who was on insulin pump therapy, developed high blood glucose (BG) level due to pump malfunction. She gave herself 7 ml (700 units) instead of 7 units by an error. She presented to hospital 2 hours later when this was recognized. The initial BG in the emergency room was 13.9 mmol/L. A dextrose infusion was started 6 hours after the insulin injections when her BG dropped significantly before it reached a lowest level of 3.3 mmol/L 9 hours after the event. It was only possible to discontinue this infusion 15 hours after insulin injections when BG was stable.
Conclusion: Hypoglycemia could be delayed in insulin overdose in diabetic children. This may necessitate prolonged monitoring beyond the usual half-life of insulin.

Key words: Insulin, overdose, delayed hypoglycemia, dextrose, glucagon, aspart, diabetes, case report